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Tuberculosis is classically divided into states of latent infection and active disease. Using combined positron emission and computed tomography in 35 asymptomatic, antiretroviral-therapy-naive, HIV-1-infected adults with latent tuberculosis, we identified ten individuals with pulmonary abnormalities suggestive of subclinical, active disease who were substantially more likely to progress to clinical disease. Our findings challenge the conventional two-state paradigm and may aid future identification of biomarkers that are predictive of progression.

Original publication




Journal article


Nat Med

Publication Date





1090 - 1093


Adult, Coinfection, Disease Progression, Female, Fluorodeoxyglucose F18, HIV Infections, Humans, Interferon-gamma Release Tests, Latent Tuberculosis, Male, Mycobacterium tuberculosis, Positron Emission Tomography Computed Tomography, Radiography, Thoracic, Radiopharmaceuticals, South Africa, Sputum, Tuberculosis, Tuberculosis, Pulmonary